Researchers in the Ludwig Center at the Johns Hopkins Kimmel Cancer Center report they have identified a drug treatment that could—if given early enough—potentially reduce the risk of death from the most serious complication of Coronavirus disease 2019 (COVID-19), also known as SARS-CoV-2 infection. Phys.org reports that prazosin, a U.S. Food and Drug Administration-approved alpha blocker that relaxes blood vessels, may specifically target an extreme inflammatory process often referred to as cytokine storm syndrome (CSS) that disproportionately affects older adults with underlying health conditions, and is associated with disease severity and increased risk of death in COVID-19 infection. Using it pre-emptively to address COVID-19-associated hyperinflammation of the lungs and other organs has the potential to reduce deaths in the most vulnerable populations, they say.

Researchers at Peking University (PKU) has successfully identified multiple highly potent neutralizing antibodies against the novel coronavirus SARS-CoV-2, the causative virus of the respiratory disease COVID-19, from convalescent plasma by high-throughput single-cell sequencing. Phys.org notes that neutralizing antibodies, generated by human immune system, can effectively prevent viruses from infecting cells. New results from animal studies showed that their neutralizing antibody provides a potential cure for COVID-19 as well as means for short-term prevention. This marks a major milestone in the fight against the pandemic.

More randomized, double-blind clinical trials of the use of hydroxychloroquine for treating COVID-19-infected patients find what earlier studies have found: hydroxychloroquine offers no benefits to trial subjects relative to the placebos given to the control group – but hydroxychloroquine significantly increase the risks of serious side-effects. Promoters of hydroxychloroquine argue that the drug is more effective in the early stages of infections, but in these two recent trials the drug was given to people in the early infection stage and showing only mild symptoms, with the same disappointing results. BMJ says that while further work is needed to confirm these results, the authors say that their findings do not support the use of hydroxychloroquine to treat patients with persistent mild to moderate COVID-19.

Scientists are putting an herbal remedy from Madagascar, purported to cure COVID-19, to the test. Salem Solomon writes in VOA News that researchers at Germany’s Max Planck Institute of Colloids and Interfaces, in Potsdam, are collaborating with a U.S. company, ArtemiLife, to test an extract from the plant Artemisia annuato determine its effectiveness in speeding recovery from the virus.

An experimental vaccine against the coronavirus being tested in Seattle showed encouraging results in very early testing, triggering hoped-for immune responses in eight healthy, middle-aged volunteers, its maker announced Monday. King5 reports that study volunteers given either a low or medium dose of the vaccine by Cambridge, Massachusetts-based Moderna Inc. had antibodies similar to those seen in people who have recovered from COVID-19. The study was run out of the Kaiser Permanente Washington Health Research Institute In the next phase of the study, led by the U.S. National Institutes of Health, researchers will try to determine which dose is best for a definitive experiment that they aim to start in July.

The first hints that a vaccine can train people’s immune system to fight coronavirus have been reported by a company in the U.S. James Gallagher writes for the BBC that Moderna said neutralizing antibodies were found in the first eight people who took part in their safety trials. It also said the immune response was similar to that in people infected with the actual virus. Larger trials to see whether the jab protects against infection are expected to start in July. Work on a coronavirus vaccine has been taking place at unprecedented speed, with around 80 groups around the world working on them. Moderna was the first to test an experimental vaccine, called mRNA-1273, in people. The vaccine is a small snippet of the coronavirus’s genetic code, which is injected into the patient. It is not capable of causing an infection or the symptoms of COVID-19, but is enough to provoke a response from the immune system.

An international team of researchers led by Dr. Eleanor Fish, Scientist Emeritus at the Toronto General Hospital Research Institute, UHN, and professor in the University of Toronto’s Department of Immunology, has shown for the first time that an antiviral drug can help speed up the recovery of COVID-19 patients. UHN reports that according to the new study, published Friday in Frontiers in Immunology, treatment with interferon(IFN)- α2b may significantly accelerate virus clearance and reduce levels of inflammatory proteins in COVID-19 patients. The research team found that treatment with this drug, which has been used clinically for many years, significantly reduced the duration of detectable virus in the upper respiratory tract, on average by about seven days. It also reduced blood levels of interleukin(IL)-6 and C-reactive protein (CRP), two inflammatory proteins found in COVID-19 patients.

The study of viruses once challenged the world’s notion of what is “biological,” and for a time it was not clear whether viruses were regulated by the Biological Weapons Convention (BWC). Durward Johnson and James Kraska write that “SynBio and its convergence with emerging technologies may create weapons not currently banned by universal disarmament obligations or customary international law, and this legal gap raises the prospect of weaponization of nonbiological threat agents tailor-made to create targeted effects. These tactical biotechnological capabilities could have potentially strategic consequences and yet may fall outside the existing regime.”

Development of vaccines against COVID-19 hinges on “unprecedented” and transparent cooperation among industry, government, and academia, according to a commentary by Anthony Fauci and other U.S. vaccine experts published yesterday in Science. Mary Van Beusekom writes in CIDRAP that the authors, noting that all vaccine platforms have advantages and disadvantages and underscoring the need for speed and flexibility of manufacture, safety, long-term efficacy, scale, affordability, vaccine stability, and a temperature-controlled supply chain, said that “no single vaccine or vaccine platform alone is likely to meet the global need, and so a strategic approach to the multi-pronged endeavor is absolutely critical.”

An international team of researchers has developed a new mathematical tool that could help scientists to deliver more accurate predictions of how diseases, including COVID-19, spread through towns and cities around the world. Rebecca Morrison, an assistant professor of computer science at CU Boulder, led the research. CU says that for years, she has run a repair shop of sorts for mathematical models—those strings of equations and assumptions that scientists use to better understand the world around them, from the trajectory of climate change to how chemicals burn up in an explosion. As Morrison put it, “My work starts when models start to fail.”

U.S. regulators on Friday allowed emergency use of remdesivir, the first drug that appears to help some COVID-19 patients recover faster, a milestone in the global search for effective therapies against the coronavirus. Matthew Perrone and Marilynn Marchione write for AP that the Food and Drug Administration cleared Gilead Science’s intravenous drug for hospitalized patients with “severe disease,” such as those experiencing breathing problems requiring supplemental oxygen or ventilators. The FDA acted after preliminary results from a government-sponsored study showed that the drug, remdesivir, shortened the time to recovery by 31%, or about four days on average, for hospitalized COVID-19 patients. Those given the drug were able to leave the hospital in 11 days on average vs. 15 days for the comparison group. The drug may also help avert deaths, but that effect is not yet large enough for scientists to know for sure. The National Institutes of Health’s Dr. Anthony Fauci said Wednesday the drug would become a new standard of care for severely ill COVID-19 patients. Remdesivir, which blocks an enzyme the virus uses to copy its genetic material, has not been tested on people with milder illness. The FDA previously allowed narrow use of a malaria drug, hydroxychloroquine, for hospitalized patients who were unable to take part in ongoing studies of the medication. President Trump touted the drug as a “game changer” and repeatedly promoted it as a possible COVID-19 treatment, but no large high-quality studies have shown the drug works for that and it has significant safety concerns.

In a brief report published today in JAMA Cardiology, a team of pharmacists and clinicians at Beth Israel Deaconess Medical Center (BIDMC) found evidence suggesting that patients who received hydroxychloroquine for COVID-19 were at increased risk of electrical changes to the heart and cardiac arrhythmias. The combination of hydroxychloroquine with azithromycin was linked to even greater changes compared to hydroxychloroquine alone. Hydroxychloroquine and azithromycin each can cause an electrical disturbance in the heart known as a QTc prolongation, indicated by a longer space between specific peaks on an electrocardiogram. QTc prolongation denotes that the heart muscle is taking milliseconds longer than normal to recharge between beats. The researchers note that the delay can cause cardiac arrhythmias, which in turn increases the likelihood of cardiac arrest, stroke, or death. “While hydroxychloroquine and azithromycin are generally well-tolerated medications, increased usage in the context of COVID-19 will likely increase the frequency of adverse drug events (ADEs),” said co-first author Nicholas J. Mercuro, PharmD, a pharmacy specialist in infectious diseases at BIDMC. Senior author Howard S. Gold, MD, an infectious disease specialist at BIDMC and an assistant professor of medicine at Harvard Medical School, said: “Based on our current knowledge, hydroxychloroquine for the treatment of COVID-19 should probably be limited to clinical trials.”

It has become increasingly clear that, depending on the computer model used, either we could still be in the midst of the pandemic with rising numbers of cases and deaths or we could be nearing the time to reintroduce society to normal operations. Why such disparity? Because each model works a bit differently and depending on the model used and assumptions added in, the results will change, sometimes dramatically.

Leading biomedical ethicists are calling on the global research community to resist treating the urgency of the current COVID-19 outbreak as grounds for making exceptions to rigorous research standards in pursuit of treatments and vaccines. Crises are no excuse for lowering scientific standards, the authors of a paper, titled “Against Pandemic Research Exceptionalism,” argue.

A retrospective study of patients with COVID-19 found no evidence that the anti-malaria drug hydroxychloroquine, either with or without the antibiotic azithromycin, reduced mortality or the need for mechanical ventilation. Researchers also found that hydroxychloroquine alone was associated with increased mortality. Early excitement about the combination was based on a small French study, and President Donald Trump soon began touting the combination as a potential “game changer,” but the findings from the study, which is the largest to date to report on outcomes from treating COVID-19 patients with the anti-malaria drug and uses a database that has been used for many different studies, suggest that the hydroxychloroquine/azithromycin combination may not be as promising for treating COVID-19 as some have hoped.

The long view

Since the onset of the coronavirus crisis, governments, analysts, and health organizations have released different statistical models addressing the disease – and its numerical manifestations: the number of people likely to be infected; hospitalized; treated in the ICUs; or die. Different models offer different numbers and different trajectories. Which one of them is right? Zeynep Tufecki writes that “The answer is both difficult and simple. Here’s the difficult part: There is no right answer. But here’s the simple part: Right answers are not what epidemiological models are for.” The most important function of epidemiological models is as a simulation, a way to see our potential futures ahead of time, and how that interacts with the choices we make today. Thus, epidemiological models do not give us certainty – they give us something much more important: “agency to identify and calibrate our actions with the goal of shaping our future.”

Germs have killed more people than all the wars in history, and people have been trying to make use of them throughout all those wars. In the U.S., we have seen small-scale bioterrorist attacks – the Rajneeshee poisoning of restaurants in 1986 and the Amerithrax letters that were mailed in 2001. Still, the years running up to this current coronavirus pandemic not only saw the gutting of U.S. national health institutions but also a cultural groundswell of science denial in the anti-vaccination movement. Today the United States in particular is paying for that denial in livelihoods and lives. The warnings were clear. If 9/11 was a “failure of imagination,” then history will no doubt judge the Trump administration’s response to COVID-19 as a failure of courage, compassion, and, most of all, competence.